CROSSING THE DIGITAL DIVIDE: ASSESSING DIGITAL READINESS AMONG UNDERSERVED OLDER ADULTS

Abstract The California Department of Aging launched the “Connecting, Health, Aging, & Technology (CHAT) Program, “aimed at bridging the digital divide and mitigating social isolation among older adults by providing an iPad device and technology training. Because providing a device does not guarantee uptake, we examined factors associated with technology adoption among research participants (n=1,219). We used a global “digital readiness” scale, and two open-ended questions to examine potential device uptake. We ran multivariate regressions with explanatory independent variables including demographic characteristics (age, gender, race/ethnicity, living arrangement, and education), health indicators (self-rated health and mental health status) and the intention to adopt technology against the global readiness question. The analysis showed that digital readiness was associated with age and education, and Asian or Pacific Islander older adults were more ready than non-Hispanic Whites. Further, digital readiness was negatively associated with mental health but positively associated with self-rated health. Digital readiness was also associated with an increased intention to adopt technology. A content analysis of the open-ended questions in Atlas.ti informed the regression analyses and revealed participants’ strong desire for digital self-efficacy, informed citizenship, lifelong learning, a proactive desire to improve quality of life, and the desire to foster connection to family and friends. Our research highlights the personal and multifaceted nature of technology adoption among older adults, and the complexity of fostering digital inclusion on a large scale.

between sleep behaviors (duration, napping frequency, feeling rested) and couples' sexual frequency, quality, and pleasure were similar among dyads in which one spouse was providing care to a spouse (n = 146) or a parent or other care recipient (n = 211).Using Wave 2 of the NSHAP and actor-partner interdependence models, we found significant differences (p <.01) between dyads.For all spouses, only frequency of sharing a bed was related to frequency of sexual activity in the previous 12 months.Sleep duration was not associated with any outcomes.In both groups, frequency of sharing a bed was positively associated with reports of physical pleasure (b's ranged from .20 to .50).In spousal caregiver couples, caregivers' greater napping frequency was negatively associated (b = -.29,p <.01) with their partner's reports of a physically pleasurable relationship, and their reports of feeling rested were positively (b = .17,p < .01)associated with their own reports of pleasure.For couples in which the caregiver was caring for a non-spouse, there were actor effects for caregivers' and noncaregivers' napping frequency on lower reports of sexual relationship quality (b = .19 and .49, respectively), and a partner effect for noncaregivers (b = .25).These results point to the importance of understanding the context of caregiving, sleep behaviors, and sexual relationships.

THE PROMISE OF DIGITAL INCLUSION FOR OLDER ADULTS: BUILDING BRIDGES FOR UNDERSERVED OLDER ADULTS IN TWO STATES
Chair: Skye Leedahl Co-Chair: Kathleen Wilber Discussant: Namkee Choi Digital inclusion refers to activities completed to ensure that all individuals, especially those who are underserved, have access to and are able to utilize technology and needed support.This includes affordable, robust internet service; devices; digital literacy training; technical support; and applications/online content (National Digital Inclusion Alliance, 2022).Recognizing digital exclusion among older adults as a major public health and social equity concern, particularly during the pandemic, two states (California and Rhode Island) partnered with their respective state units on aging to offer technological devices (e.g., iPads) and intergenerational support to underserved older adults who speak multiple languages across the states.The university-based programs worked with their local Areas Agencies on Aging (CA) and senior centers (RI) through the State units on Aging to recruit and support older participants.This symposium will describe findings from three research projects within these large, ongoing research initiatives and discuss some of the lessons learned for conducting this type of applied research.The first paper by Marnfeldt and colleagues describes factors associated with digital readiness among participants.The second paper by Leedahl and colleagues examines predictors of digital competence among those interested in the program.The third paper by Tsotsoros and colleagues examines the influence of technological growth on various social well-being measures.The fourth paper by Batista-Malat and colleagues describes the strengths and barriers in working with community partners when completing applied research.

PREDICTORS OF DIGITAL COMPETENCE AMONG OLDER ADULTS INTERESTED IN AN INTERGENERATIONAL TECHNOLOGY PROGRAM
Skye Leedahl, Cindy Tsotsoros, Alexandria Capolino, and Josie Santilli, University of Rhode Island, Kingston, Rhode Island, United States The Rhode Island Office of Healthy Aging initiated a digiAGE collaborative.As a major part of this initiative, the University of Rhode Island launched the Engaging Generations: Cyber-Seniors digiAGE iPad Program and research project.We analyzed participants who took part in the study in 2021 and 2022 (N=324; age range=50-92; 77.2% female, 22.5% male; 65.1% White, 16.4% Hispanic, 11.4% Black, 4.9% Native American or Alaska Native, 1.2% Asian, 1.9% Multiple races; 83.6% English, 15.4% Spanish as primary language).In this study, we examined demographic characteristics (e.g., income, marital status, employment status, primary language, living alone status, education, gender, race/ethnicity, and Wifi access), and social well-being characteristics (e.g., depression, social isolation, loneliness, quality of life) as predictors of digital competence using structural equation modeling.Overall, this model showed excellent fit (2(53, N=324)=104.29, p<.05, with CFI = .96,TLI = .92,RMSEA = .06,CMIN/df= 1.97).The model indicated several direct and indirect effects.For indirect effects, income status predicted depressive symptoms, depressive symptoms predicted quality of life, and quality of life predicted digital competence.For direct effects, having access to a wireless internet connection within the home and education level predicted digital competence (Adj.R Square = 0.112).As technology becomes increasingly integrated into our daily lives, examining predictors of digital competence among older adults is important to identify whom to target for digital inclusion initiatives and how to provide support appropriately.The California Department of Aging launched the "Connecting, Health, Aging, & Technology (CHAT) Program, "aimed at bridging the digital divide and mitigating social isolation among older adults by providing an iPad device and technology training.Because providing a device does not guarantee uptake, we examined factors associated with technology adoption among research participants (n=1,219).We used a global "digital readiness" scale, and two open-ended questions to examine potential device uptake.We ran multivariate regressions with explanatory independent variables including demographic characteristics (age, gender, race/ethnicity, living arrangement, and education), health indicators (self-rated health and mental health status) and the intention to adopt technology against the global readiness question.The analysis showed that digital readiness was associated with age and education, and Asian or Pacific Islander older adults were more ready than non-Hispanic Whites.Further, digital readiness was negatively associated with mental health but positively associated with we compared and contrasted challenges and lessons learned administering digital inclusion projects in California and Rhode Island.In California, challenges included the complexity of state and local interface, managing public-private partnerships, and deciding on and communicating roles and responsibilities through the required formal channels.In Rhode Island, timing and communication were challenging because universities and community partners operate on different calendar systems and cater to different demands.For both programs, ensuring that training and technical support were available, accessible, and appropriate for diverse populations of older adults was a challenge.However, the training and support approaches were different as California leveraged private and non-profit partnerships while Rhode Island used university student mentors.Further, the rollout and data collection needed to evaluate the programs created barriers and slowed the process, including partners' language capabilities not matching the participants' and the time-consuming nature of data collection via telephone.Nevertheless, in both states, research opportunities afforded by collaborating with state and local agencies and private sector providers were invaluable.Partnerships allowed older adults to participate in research via a trusted organization with linguistic and cultural sensitivity, and researchers accessed underserved populations less likely to participate in research.

ASSISTED LIVING AND HOME CARE OF OLDER ADULTS
Abstract citation ID: igad104.1721

CLINICAL NOTES AND CARE COORDINATION CALLS AS IMPORTANT PREDICTORS OF EMERGENCY CARE UTILIZATION IN HOME HEALTH CARE Lauren Evans, VNS Health, New York City, New York, United States
Home care patients experience a high illness burden and a heightened risk of negative health outcomes.There is a need to understand how clinician behaviors, including notetaking and care coordination activities, can be better integrated into risk modelling in home care settings.This study predicted hospitalization/ED visits using data from 86,866 home care episodes from an agency in the Northeastern United States.We began our analysis with nearly 200 variables, including patient-related factors (e.g., comorbidities, types of medications taken, functional status), and factors relating to clinician behavior, such as problems documented in clinical notes, and calling patterns to the patient or medical care providers.We used least absolute shrinkage and selection operator (LASSO) to aid in the selection of the best subset of variables.In our preliminary analysis, we found that two clinician behavior-related factors were the strongest risk factors for experiencing hospitalization/ED visits, specifically the proportion of concerning notes generated during the care episode (OR 8.97,95% CI 7.64,10.52),and a measure reflecting frequent calls to the patient's family (OR 4.51,95% CI 3.80,5.37).Clinician documentation of specific problems, and the clinician's decision to conduct a medication review